摘要
目的分析心脏瓣膜手术同期冠状动脉旁路手术治疗冠心病合并瓣膜病利弊。方法 2011年1月—2016年12月医院共采用瓣膜手术同期冠状动脉旁路手术患者56例纳入同期组,同期单纯的心脏瓣膜手术104例纳入对照组。对比近远期预后、手术与住院情况。结果同期组体外循环、主动脉阻断、术后呼吸机使用时间、ICU监护时间、住院时间,左心室射血分数上升幅度分别为(3.1±0.3)h、(1.5±0.3)h、(28.4±2.4)h、(71.5±11.4)h、(14.4±2.5)d、(14.4±5.6)%,高于对照组(1.9±0.7)h、(1.1±0.4)h、(25.5±4.6)h、(60.5±12.3)h、(12.8±4.3)d、(10.5±6.3)%,差异有统计学意义(P<0.05)。同期组近期并发症发生率39.29%高于对照组9.62%,同期组术后6个月心脏不良事件发生率0.00%低于对照组9.62%,差异有统计学意义(P<0.05)。结论心脏瓣膜手术同期冠状动脉旁路手术治疗冠心病合并瓣膜病能够改善远期预后,但近期并发症发生率较高,可能与体外循环、阻断时间延长有关。
Objective To analyze the advantages and disadvantages of cardiac valves surgery combined with coronary bypass surgery in treatment of contrary heart disease and valvular heart disease.Methods 56 cases of patients with cardiac valves surgery combined with coronary bypass surgery in our hospital from January 2011 to December 2016 were selected as the homochronous group,while 104 cases of patients with simple cardiac valves surgery at the same period were selected as the control group,and the long-term and short-term prognosis,surgery and hospitalization situations were compared between the two groups.Results The extracorporeal circulation,aortic cross-clamping,ventilator use time after surgery,ICU monitoring time,length of stay,and left ventricular ejection fraction increase degrees in the homochronous group were higher than those in the control group,[(3.1±0.3)h,(1.5±0.3)h,(28.4±2.4)h,(71.5±11.4)h,(14.4±2.5)d,(14.4±5.6)%vs(1.9±0.7)h,(1.1±0.4)h,(25.5±4.6)h,(60.5±12.3)h,(12.8±4.3)d,(10.5±6.3)%],and the differences were statistically significant(P<0.05),the incidence rate of short-term complications was higher than that in the control group,(39.29%vs 9.62%),and the incidence rate of adverse cardiac events after 6-month surgery was lower than that in the control group,(0.00%vs 9.62%),and the differences were statistically significant(P<0.05).Conclusion Cardiac valves surgery combined with coronary bypass surgery in treatment of contrary heart disease and valvular heart disease can improve the long-term prognosis,but the incidence rate of short-term complications is high,which may be related to the extracorporeal circulation and cross-clamping time.
作者
蔡文龙
CAI Wen-long(Second Department of Cardiac Surgery,Fujian Provincial Hospital,Fuzhou,Fujian Province,350000 China)
出处
《中外医疗》
2017年第35期62-63,66,共3页
China & Foreign Medical Treatment
关键词
冠心病
瓣膜病
心脏瓣膜手术
冠脉旁路手术
Coronary heart disease
Valvular heart disease
Cardiac valves surgery
Coronary bypass surgery
作者简介
蔡文龙(1987-),男,福建福州人,硕士,住院医师,研究方向:心血管外科。
